Funding supports innovative tele-psychiatry and counseling services

Feb. 3, 2017 — In an effort to meet the growing need for mental and behavioral health services, the PATH Foundation is funding tele-psychiatry and remote mental health services at the Fauquier Free Clinic. Created to fill gaps in local resources, a grant of $370,000 was awarded for the program’s start-up costs and first year of operation.

Rob Marino, Executive Director of the Fauquier Free Clinic, says the services have helped meet a substantially growing need, “When we started the program in late October, we had 33 patients on our waiting list for behavioral health services. Our volunteer therapists do great work, but the number of patients in need greatly exceeds their available time. Plus, we didn’t have any psychiatry services available. Adding the telehealth option has made an incredible difference for our patients, but it’s also made a difference for our physicians. Having the resources to refer a patient to specialists leads to overall better care.”The process began with a six-month planning grant from the PATH Foundation to the Fauquier Free Clinic and the Mental Health Association of Fauquier County. They worked with a 22-member planning team, including representatives from Fauquier Health, the Community Services Board, 13 primary care physicians and others, to develop a plan to increase access to behavioral health care through integrated and coordinated services using telehealth technology.

While some patients directly seek out mental health services, all patients at the clinic are screened for depression as behavioral health problems can negatively affect the management of physical illnesses and health outcomes. About half of the patients receiving mental health services are referred from those screenings.

This collaborative care model goes beyond mental health – with medical, dental and mental health services under one roof, patients can be referred across specialties to ensure overall health needs are addressed. In an October 2012 Cochrane Review article, 79 randomized controlled trials showed that collaborative care models – like those at the Fauquier Free Clinic – are the best approach to treating depression.

Shannon Raybuck, the clinic’s Mental Health Care Coordinator, is the first contact to help assess the best way to help each patient. “It’s so important that our patients get the individual help they need. I meet with each one to better understand what level of care to recommend, then we’re able to initiate a treatment plan.” A licensed professional counselor, Shannon can also see patients.

Patients receiving telehealth services are able to meet with the same psychiatrist or therapist to ensure they are able to establish a relationship. Two rooms with large computer screens, equipped with cameras and microphones, allow patients to talk with their provider. Patients have shared with Shannon that it’s not as impersonal as it may sound, “I’ve heard from many patients that after the first couple of minutes, they forget they’re meeting remotely. And as people have gotten more used to this type of communication, it isn’t as foreign as it once may have seemed.”

Sallie Morgan, Executive Director of the Mental Health Association of Fauquier County, liked the idea of bringing tele-psychiatry to the Fauquier Free Clinic, “Behavioral health is certainly a community-wide issue, but with a critical shortage of local mental health professionals, patients eligible for care at the clinic are an especially vulnerable population. Hopefully in the near future this can be an option for the broader community.”

The numbers show that the program is reaching the patients in need. In December, of the 70 patients treated, half used the telehealth services (12 psychiatry, 23 counseling). January’s numbers rose to a total of 107 patients receiving mental health services, with 54 patients using telehealth services (23 psychiatry, 31 counseling). The Fauquier Free Clinic offers care to uninsured and low income residents of Fauquier and Rappahannock, though telehealth services are currently only available at the clinic’s Warrenton office.

Rob said that this increased need in mental health services is being seen at similar clinics all across Virginia. The Fauquier Free Clinic’s program is one of the first to add telehealth services, and it is expected to be a model for others to follow.

Christy Connolly, President and CEO of the PATH Foundation, said support of the effort was important to both the board and staff, “With mental health as one of our core areas of focus, we felt this was a great opportunity to offer these services to patients of the Fauquier Free Clinic. Like many rural communities, our area is incredibly underserved in psychiatric and mental health providers. This program’s value can’t be overstated.”